Symptomatic vascular ring due to double aortic arch: A report of two cases

Vascular ring anomalies, represented mainly by the double aortic arch (DAA), account for about 1% of congenital cardiovascular anomalies and are characterized by tracheoesophageal compression due to encircling vascular or ligamentous structures. These anomalies arise from the failure of the right fourth aortic arch to regress during embryonic development, leading to symptoms ranging from respiratory distress to dysphagia. Diagnostic imaging includes chest radiography, CT, MRI, and echocardiography, each with specific considerations, especially in pediatric patients. Management, often surgical, focuses on relieving compression symptoms and has a favorable prognosis. This case series emphasizes the manifestations of the double aortic arch, whether it be respiratory distress or dysphagia, and addresses both right and left dominant arches.